2016-2019 IMPLEMENTATION STRATEGY...The implementation strategy was developed after the comprehensive community health needs assessment (CHNA) was completed. Please refer to the complete

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2016-2019 IMPLEMENTATION STRATEGY

August 4, 2016

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Steering Committee Members

Stacey Brandt Vice President, Marketing and Strategic Planning

Carrie Browne Project Director, Healthier Jupiter

Gail Cooper-Parks Health & Wellness Navigator, Women’s Health Navigator

Susan Denny Director, Medical Information Services

Kristi Edwards, PT Director, Rehabilitation Services

Melinda Frantz Program Facilitator, Wellness in Motion

Sue Goulding Marketing Coordinator

Siobhan Gross, RN, BSN, CDE Registered Nurse, Certified Diabetes Educator

Dale Hocking, CPA Vice President, Finance, Chief Financial Officer

David Jones Controller

Stacey Justine, M.S. Rehab Operations Manager

Barbara Lamia, MSN, RN, CCRN, BC Director, Cardiovascular and Clinical Support Services

Sherri Lewman Vice President, Service Line Growth

Judy Magalhaes Vice President, Outpatient Services

JoAnn Moretti Director, Quality and Compliance, Oncology Administration

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Amy L. Pepper, MBA MyClinic Director

Corey T. Redlich Director, Patient Financial Services

Steven Seeley, MSN RN CENP CEN CPHQ Vice President, Chief Operating Officer, Chief Nursing Officer

Terri Wentz Vice President, Clinical Integration

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Table of Contents

Steering Committee Members ..........................................................................................2

Table of Contents .................................................................................................................4

I. Executive Summary .........................................................................................................5

Introduction ........................................................................................................................................... 5

How the Implementation Strategy was Developed ................................................................... 6

II. Identified Community Health Needs ........................................................................7

Health Needs Identified ...................................................................................................................... 7

III. Addressing Health Needs ...........................................................................................8

Cancer ...................................................................................................................................................... 8

Heart Disease ...................................................................................................................................... 10

Nutrition, Exercise & Diabetes ........................................................................................................ 11

IV. Significant Health Needs Not Addressed .............................................................. 14

V. Conclusion ....................................................................................................................... 14

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I. Executive Summary

Introduction

Jupiter Medical Center, Inc. (hereinafter referred to as “JMC” or Jupiter Medical Center) is a not-for-profit regional medical center consisting of 207 private acute-care hospital beds. The affiliates of JMC include a 120-bed long-term care and sub-acute rehabilitation facility as well as a physician group that offers a broad range of specialty services. JMC is reimagining how to restore the community’s health and wellness. Award-winning physicians, world-class partnerships, and innovative techniques and technology enable JMC to provide a broad range of services with specialty concentrations including cardiology, oncology, imaging, orthopedics & spine, digestive health, emergency services, lung & thoracic, women’s health, weight management, pediatric care, urgent care and men’s health. Founded in 1979, Jupiter Medical Center has approximately 1,500 employees, 575 physicians, and 640 volunteers. JMC continues to perform in the top 10% of hospitals nationwide for patient quality and satisfaction. JMC’s mission is to deliver excellent and compassionate health care advancing the well-being of the people it serves. JMC fulfills its mission by focusing on the following core values in order to be recognized as the leading health care organization in the region: Respect, Integrity, Excellence, Accountability, Teamwork and Courage.

JMC works closely with MyClinic, an independent, not-for-profit free clinic that provides primary medical care, referrals for urgent dental services and medical specialists and on-site behavioral health services to low income, uninsured adults who live in the greater Jupiter area.

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How the Implementation Strategy was Developed

The implementation strategy was developed after the comprehensive community health needs assessment (CHNA) was completed. Please refer to the complete CHNA for the full report. Strategies and action plans were developed based on a consensus among steering committee members after input from each of the respective disciplines.

Jupiter Medical Center has developed specific action plans to address cancer, heart disease and nutrition, exercise & diabetes, and increase access to care in each of these areas.

The organization intends to undertake the following programs and services to meet the identified community health needs:

1. Cancer

a. Increase skin cancer screenings and CT (computed tomography) lung screenings

b. Begin offering breast diagnostic imaging services for MyClinic patients who are low-income and medically underserved individuals

c. Expand multidisciplinary clinics and expand healthcare navigation services d. Expand oncology services offered

2. Heart Disease

a. Increase cardiac screenings and provide additional access to screenings b. Expand chronic disease management services

3. Nutrition, Exercise & Diabetes

a. Expand health coaching and exercise services offered b. Continue JMC’s support of Healthier Jupiter c. Increase healthy-lifestyle education provided to the community

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II. Identified Community Health Needs

Health Needs Identified

The health needs that have been identified by Jupiter Medical Center as the top three priority health needs are as follows (and each described in further detail in Section III hereof):

1. Cancer. Cancer is the first leading cause of death in Martin County and the second leading cause of death in Palm Beach County. Cancer is also the first leading cause of death in JMC’s primary service area, and the second leading cause of death in JMC’s secondary service area.

2. Heart Disease. Heart disease is the first leading cause of death in Palm Beach County and the second leading cause of death in Martin County. Heart disease is also the first leading cause of death in JMC’s secondary service area, and the second leading cause of death in JMC’s primary service area. Heart disease includes conditions affecting the heart, such as coronary heart disease, heart attack, congestive heart failure, and congenital heart disease.

3. Nutrition, Exercise & Diabetes. Nutrition, exercise and diabetes were

combined into one significant health need based on all three being focused on preventative health. This was selected as a significant health need based on the community leader interviews and community surveys. This broad category includes the need for increased focus on maintaining a healthy lifestyle which includes nutrition and exercise. In addition, diabetes is a significant health need because it is the seventh leading cause of death in JMC’s primary and secondary service areas.

In addition to the top three health needs identified above, the Steering Committee identified that access to care is also a health need of the community. Instead of this being a separate identified health need, the committee thought it was important to ensure access to care is addressed in each of the action plans for cancer, heart disease and nutrition, exercise and diabetes. One of the ways that JMC devotes resources to improving access to care is the support that is provided to MyClinic, a free clinic that provides medical care to low income adults. The importance of ensuring access to care is emphasized within each of the action steps described below for addressing the top three health needs.

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III. Addressing Health Needs

1. Cancer Cancer is the first leading cause of death in Martin County and the second leading cause of death in Palm Beach County. Jupiter Medical Center’s Ella Milbank Foshay Cancer Center is the only comprehensive cancer program in northern Palm Beach County. Comprehensive services include:

Surgery

Radiation Therapy Chemotherapy & Infusion Clinical Trials Patient Navigation Services Cancer Rehabilitation Services

Survivorship Services Comprehensive Breast Care Program Thoracic Surgery & Lung Center of Excellence Community Outreach: Screenings, Education & Lectures

Due to the need in the community, Jupiter Medical Center will invest additional resources and take additional action steps in order to address this health need. ACTIONS THE HOSPITAL PLANS TO TAKE TO ADDRESS THE HEALTH NEED The specific actions the hospital plans to take address cancer in the community are as follows:

Increase skin cancer screenings to 4 annually and CT lung screenings by 10% annually.

JMC already offers these types of screenings to promote early detection of melanoma and lung cancer. JMC currently provides health events and educational programs to the community at which these screenings are offered. However, JMC plans to increase the number of screenings offered annually by investing in further community outreach. JMC will offer one skin cancer screening quarterly and will increase CT lung screenings by 10% each fiscal year.

Begin offering diagnostic breast imaging services for MyClinic patients.

JMC plans to begin offering breast diagnostic imaging services MyClinic patients. JMC currently offers these services to hospital patients but plans to expand these services to

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the patients at MyClinic to ensure these services are available to low-income individuals in the community.

Expand patient participation in multidisciplinary clinics and increase patient navigator availability.

JMC’s multidisciplinary clinics offer a central point of service for patients to see all of the necessary physician specialists and medical care providers in one place at one time. JMC currently offers a multidisciplinary clinic for breast, lung and gynecologic cancer patients, but plans to expand clinics to other types of cancer. JMC’s plan to expand the multidisciplinary approach to several additional types of cancer will provide a better experience for patients and improve patients’ access to each of the care providers. JMC’s patient navigators are healthcare providers who work directly with the patient to navigate the healthcare system. The navigators locate area resources, provide information to the patient, listen and coach on health-related issues, and guide patients to the appropriate appointments and screenings. JMC currently offers this service to breast and lung cancer patients, but plans to expand navigation service for other types of cancer, such as melanoma and prostate cancer, to provide these patients assistance as they receive treatment and improve access to care.

Expand oncology services offered. JMC will continue to expand oncology services offered including the addition of new surgical oncologists who will join the JMC medical staff. The new physicians will provide world-class care to a broader range of patients and allow JMC to provide medical care to more individuals in the community. The expanded oncology services will allow the JMC community to access highly-trained experts and state-of-the-art treatment for cancer. In addition, the organization plans to construct a new cancer center to offer all services in one location and to provide convenience and accessibility for patients. RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE NEED JMC plans to continue to commit resources to address cancer and move forward with the actions described above. In addition, the new cancer center will represent a significant investment of JMC’s resources.

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PLANNED COLLABORATION IN ADDRESSING THE HEALTH NEED JMC’s cancer program works closely with community organizations including the American Cancer Society, Susan B. Komen Foundation, Cancer Alliance of Help & Hope, Hearing the Ovarian Cancer Whisper and the Melanoma Foundation. These organizations offer a variety of services including patient education material, transportation and financial assistance. The program also works with the Palm Beach County Medical Society Project Access which links underserved patients to health care services and providers.

2. Heart Disease Heart disease is the first leading cause of death in Palm Beach County and the second leading cause of death in Martin County. Heart disease includes conditions affecting the heart, such as coronary heart disease, heart attack, congestive heart failure, and congenital heart disease. Mount Sinai Heart New York at Jupiter Medical Center offers the following cardiology and heart health services:

Cardiac Catheterization with two state-of-the-art cardiac catheterization labs Interventional cardiology procedures Noninvasive cardiac diagnostic testing Cardiac rehabilitation

Screenings – Coronary CT Angiography, Heart Health & Vascular Stress reduction classes Patient Health Navigator & Cardiac Patient Navigator Community outreach – education, lectures and health fairs

In addition to the services currently offered, Jupiter Medical Center will devote additional resources to address heart disease. JMC plans to become a level 2 cardiovascular facility and to expand the programs and services offered to members of the community served. ACTIONS THE HOSPITAL PLANS TO TAKE TO ADDRESS THE HEALTH NEED The specific actions the hospital plans to take to address heart disease in the community are as follows:

Increase cardiac screenings and provide additional access to screenings. JMC currently provides an extensive array of health screening options, including cardiac screenings. JMC plans to provide additional screenings and reach out to more

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individuals in order to promote early detection. In addition, JMC is developing a dedicated website focused on all of JMC’s screenings with a focus on heart health screenings. This website will continue to expand JMC’s outreach efforts. In addition to providing more screenings, the organization is developing off-site screening capabilities so that heart health and vascular screenings will become more accessible. The mobility of the screenings will allow JMC to bring them to area businesses and other locations.

Expand chronic disease management services. Because heart disease is a significant health need identified by JMC, the chronic disease management program will be expanded and will focus on heart disease and heart health. The chronic disease management services will focus on reducing future complications due to heart disease as well as other chronic conditions. In addition, the partnership that JMC has formed with Mount Sinai Heart New York will further the goal of providing world class care to cardiac patients. In addition, JMC will develop a cardiac support group that will be led by one of the cardiac nurses on staff. RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE NEED The programs described above will require additional resources to be committed. In addition, JMC will be renovating the cardiac rehabilitation space which will require additional resources. The renovation will increase JMC’s capacity to provide services to more patients. PLANNED COLLABORATION IN ADDRESSING THE HEALTH NEED As noted above, JMC will collaborate with Mount Sinai Heart New York to provide specialized expertise in cardiac health.

3. Nutrition, Exercise & Diabetes Nutrition, exercise and diabetes were combined into one significant health need based on all three being part of preventative health. This broad category includes the need for increased focus on maintaining a healthy lifestyle which includes nutrition and exercise. As noted in the CHNA, diabetes is the seventh leading cause of death in JMC’s primary and secondary service areas.

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Below are some of the services provided currently by Jupiter Medical Center:

Diabetes Education Department

Certified Diabetes Educators, one RN and one dietitian Diabetes Education Classes and individual counseling Nutrition Classes Nutrition counseling Cooking demonstrations

Community outreach through health fairs, lectures and events Cary Grossman Health & Wellness Center

o Fitness Center o Personal training o Group exercise classes including aquatic exercise o Health Coaching o Weight Management Program o Yoga and Stress Management classes o Exercise is Medicine Program

Due to the need in the community, Jupiter Medical Center will invest resources and take additional action steps to address the health need. ACTIONS THE HOSPITAL PLANS TO TAKE TO ADDRESS THE HEALTH NEED The specific actions the hospital plans to take address the need for nutrition, exercise and diabetes are as follows:

Expand health coaching and healthy lifestyle services offered. The Cary Grossman Health & Wellness Center offers a wide variety of healthy lifestyle services including biometric screenings, weight management program, fitness classes, personal training, monthly educational programs, health coaching, nutrition counseling and the Exercise is Medicine program. In addition, JMC offers healthy lifestyle sessions with a Duke University certified integrative health coach. JMC will expand the Exercise is Medicine program targeting individuals at high risk for specific diseases/conditions or those living with specific disease/conditions to encourage them to participate in exercise/fitness programs and individualized services including health coaching. The expanded services will include more programs and services available as demand grows. Specific conditions targeted include diabetes, cancer survivors and heart disease, the program focuses on prevention for those who are at high risk and how to manage living with these conditions through exercise and lifestyle changes.

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Continue JMC’s support of Healthier Jupiter. Healthier Jupiter is a community-driven health initiative designed to address health and quality of life issues from diabetes prevention and management to other areas of wellness. The goal is to create awareness of the risk factors of Type 2 diabetes in the greater Jupiter area. JMC has already provided support and resources to Healthier Jupiter but plans to continue the support provided. JMC provides resources to healthier Jupiter in the form of administrative assistance and space.

Increase education provided to the community. JMC will continue to provide nutrition classes and educational lectures offered to the community and area businesses. JMC’s community outreach program will provide educational resources at health fairs to promote wellness and healthy lifestyle. Screenings are offered at health fairs and area businesses designed to inform participants about potential risk of diabetes. Diabetes awareness events and screenings are done in collaboration with other organizations to educate the community regarding the risk of diabetes and the importance of living a healthy lifestyle. In addition, the nationally-accredited diabetes educators at JMC will provide weight loss education, specific meal plans, and information about diabetes self-management techniques. JMC plans to continue making investments in diabetes education in the community by providing education at El Sol – Jupiter’s Neighborhood Resource Center on a regular and ongoing basis. Additionally, education will continue to be provided at MyClinic up to 8 hours/month (in both English and Spanish). The Diabetes Educator/Registered Nurse collaborates with Palm Beach County School Health Advisory Council. RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE NEED JMC plans to commit staff time and other resources to address the need for increased focus on healthy lifestyle. In addition, as demand grows for additional exercise and nutrition specialists JMC will expand the services offered. PLANNED COLLABORATION IN ADDRESSING THE HEALTH NEED JMC provides resources and support to Healthier Jupiter and plans to continue this collaboration in order to bring awareness to the risk factors for diabetes and to work toward prevention. In addition, JMC works together with the Diabetes Coalition of Palm Beach County to offer free glucose screenings for diabetes and JMC diabetes educators participate in providing education about diabetes.

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In addition, the collaboration with MyClinic and El Sol provide opportunities for education and prevention services to be available to low-income individuals. Other community collaborations include the events held by the Juvenile Diabetes Research Foundation and ongoing diabetes education that is provided to the Palm Beach County school nurses.

IV. Significant Health Needs Not Addressed IRS regulations require that the Implementation Strategy include a brief explanation of why a hospital facility does not intend to address any significant health needs identified through the CHNA. As described in detail in the CHNA, JMC identified three significant health needs during the CHNA process—cancer, heart disease, and exercise/nutrition. JMC has elected to address each of the three significant health needs in this Implementation Strategy.

Other health needs identified through the CHNA process included chronic lower respiratory diseases, elder care services, and stroke. These health needs are already being addressed in some fashion by JMC and thus were not deemed significant health needs for purposes of the CHNA. Also, mental health/behavioral services is a health need that was identified through the CHNA process; however, these services are outside the scope of JMC’s service offerings.

V. Conclusion Jupiter Medical Center believes that the new programs to be developed and expanded will be a step in improving and addressing the needs of the community. Through the resources identified and collaboration with the community, the impact of these new programs will be significant. Comments regarding the Community Health Needs Assessment and/or Implementation Strategy can be submitted to the organization by contacting Stacey Brandt at [email protected], or by mail to Jupiter Medical Center, 1210 S. Old Dixie Highway, Jupiter, Florida, 33458.